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Lower back pain? will xray show herniated disk?

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So I had written a topic about my lower back pain. I went to the doctor and she got an x ray but she said nothing was wrong with my spine so she sent me to a P.T. I went and she told me I had an inflamed disc and it's pressing on nerves causing pain I'n my legs. She sent me home with instructions of icing three times a day and exercises and stretches. First I wanted to know if this is the same thing as a bulging disc?? And could it be a Hernaited disc or would the x ray show that? It's been hurting for almost 5 weeks now. I'm suppose to follow the instructions she gave me for about the next week and a half then another visit. What will happen if it isn't better by then? Just more instructions? I'm just curious because I'm so young for a back injury but I think I injured it while dancing. Any other advice on how to heal would be appreciated!!! Thanks!
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replied July 28th, 2012
Active User, very eHealthy
Quote:
First I wanted to know if this is the same thing as a bulging disc?? And could it be a Herniated disc or would the x ray show that?

My orthopedic surgeon told me a disc has to be herniated to press on a nerve to cause leg symptoms. A bulging disc is less severe meaning not so many fibers in the disc have torn. So it has not bulged far enough to hit a nerve.

Discs almost always herniate towards the back and then to one side as it progresses. The bulging to the side is what causes leg symptoms. There is a muscle imbalance which is doing this.

Discs have over 2,000 layers of fibers. These fibers attach to the bones (vertebrae) above and below. They are layered like an onion. Half of the fibers spiral to to right. The other half spiral to the left. So your disc is only half as strong when twisting compared to bending or straight compression. If there is a twist to your hips, your discs will not heal because the fibers are constantly being pulled apart.

Most disc herniations occur at L4-L5-S1 which are all 1-3 inches BELOW the top of your hip bone (iliac crest). So you can see how hip problems cause back problem.

A herniated disc would only show on an X-ray as a loss of disc height. Only bones show up on an X-ray so you would see the bones have moved closer together. This only shows up with chronic, long-term herniation. In the initial, acute phase, the disc height will be normal so your X-ray will look normal.

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What will happen if it isn't better by then?

Simple disc herniations will heal in 6 weeks. That is why doctor will say give it this long before considering surgery. BUT, if you aren't better by then you don't have to have surgery. What it means is that your muscle imbalances have not been properly addressed by your P/T. They have not given you the correct exercises.
Quote:
I'm just curious because I'm so young for a back injury but I think I injured it while dancing

Elaine Petrone is a dancer who has a story very similar to yours. She was in college when she got the same problems as you. She invented her "Miracle Ball Method" which is okay but not specific enough to treat back problems effectively IMHO.
Quote:
Any other advice on how to heal would be appreciated!!!

What exercises did your P/T give you?

There are 3 things to look at.

*** Lack of curve to your lower back ***

To put the curve back into your lower back:

1a) "Static extension on elbows" (Do a Google search)
- To get your shoulders pulled back as well, pinch your shoulders together.
--- or ---
1b) "Static back 90-90 position" (Do a Google search)
- Put a rolled up towel of 2 soft foam balls under your lower back just below your beltline.


*** Your spine is also probably shifted to one side because one hip is tighter than the other ***

To address this problem in your hips:
2a) "KNEELING LUNGE STRETCH" (Do a Google search)
2b) "STANDING LUNGE STRETCH" (Do a Google search)
- Front leg up on a step of chair will give a better front-of-hip stretch.

You will probably find one hip is tighter than the other.

To address this problem in your back:
3) HAND LEG OPPOSITE GLIDES:
a) Lie face down on the floor with arms extended straight overhead.
b) Let your ankles drop out to the sides so your feet are pigeon-toed.
c) Reach UP with the LEFT ARM and DOWN with the RIGHT LEG.
d) Now switch and reach UP with the RIGHT ARM and DOWN with the LEFT LEG.

4) "STANDING WINDMILL" (Do a Google search)
Stand with your back against the wall.
a) First shift your torso to the side, THEN bend to that side.
b) Bend left / right with your feet at 3 different widths: shoulder width -then wider -then wider still.
c) Make sure you bend just as far to the right as to the left.

5) "YOGA TRIANGLE POSE" (Do a Google search)
- Against the wall, NOT free standing!
- Keep both hips at the wall - one may try to lift off the wall.

6) "STANDING SIDE BEND" (Right side stretch)
a) Back up against a wall.
b) Feet are shoulder width apart.
c) Reach your right arm overhead.
d) Side bend to the left.
e) IMPORTANT STEP: Shift hips to the right as you press off the ground with your right leg. This will give a good stretch of your hips and entire side of your body.
f) Repeat a-e) for the left side.


*** Your hips are twisted ***

7) "Static back 90-90 position" (Do a Google search)
- Let your shoulders and hips drop equally to the floor. NO TWISTING!

8 ) "SEATED ABDUCTOR PRESS" Part I
a) Sit at the edge of a low step so your thighs are parallel to the ground.
b) Wrap a belt or Yoga strap around your thighs just ABOVE your knees.
c) Press outwards against the strap for 2 seconds. Repeat 20 times.
- Let your abs relax and your hips rotate forwards, putting an arch into your lower back.
- Do NOT let your feet roll in. Keep weight on the outer edges of your feet and off the balls of your feet.

While you are still sitting - WITH ABS RELAXED -
9) "SEATED LEG LIFTS"
- Lift your heals off the ground, toes stay on the floor. Use your hip flexors, not abs.
- As you get stronger, lift the whole leg. One leg at a time.
It is important to note that your psoas muscle is the ONLY MUSCLE that works when your thigh is bent more than 90 degrees to your torso. To really work that muscle, start sitting with your thighs horizontal to the ground and then lift the leg.
Keep your lower back arched and don't use your abs.

10) "SEATED ABDUCTOR PRESS" Part I I
a) Open the Yoga strap as long as possible / open your legs as wide as possible / wrap the strap around your calves just BELOW your knees.
- Press outwards against the strap for 2 seconds. Repeat 20 times.
- Do NOT let your feet roll in. Keep weight on the outer edges of your feet and off the balls of your feet.

It may work better doing these lying on your back on the floor. So:
8a) "SUPINE ABDUCTOR PRESS"
- Lie on your back with feet flat on the floor.
- Put the strap just above your knees.
- Put a yoga block or pillow between your feet.
- Press out against the strap as above.
8b) "SUPINE PILLOW SQUEEZE E-CISE"
- Lie on your back with feet flat on the floor.
- Put a yoga block or pillow between your knees.
- Put the strap around your ankles.
- Press into the yoga block as above.



I know this is a lot. Maybe you can print this page out and show it to your P/T. They should be familiar with what these are.

Good Luck!!!
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replied July 28th, 2012
Thanks for the info. So my PT just said it was inflamed but do you think it could be hernaited? She has me doing lower an exercises and she is telling me to tuck in my abs and butt to make the curve in my back go away and she said not to so any extension in my back because it hurts. I just hope it heals! But thanks!
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replied July 28th, 2012
Active User, very eHealthy
Quote:
So my PT just said it was inflamed but do you think it could be hernaited?

I do not know what "inflamed" would mean. I don't see how inflammation would make a disc hit a nerve unless there was something else going on as well.

Quote:
She has me doing lower an exercises and she is telling me to tuck in my abs and butt to make the curve in my back go away

Typical P/T exercises. I do not think they will fix your condition as they just create more compression on your discs. The instability comes from a muscle imbalance, NOT weakness.

You DO NOT want to make the curve in your lower back go away. It needs to be there to absorb shock from leaps, running, etc. It also needs to be there so the nerves have room to move without impingement. You may want to reduce it if it is too great. Your ballet teacher can tell you this.
Quote:
she said not to so any extension in my back because it hurts.

This is a pretty good sign of disc herniation. Once the disc nucleus pops out, bending backwards will squish it out even more.

Just give exercises 1a or 1b from my last post a try and see if you can arch your back without pain.

If not, then go on to exercises 2 and 3.
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replied July 30th, 2012
Active User, very eHealthy
JuliaElla20, I am sending you a link in your inbox. Fig 5-17 on page 125 will show correct posture will the correct curve in your lower back.
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replied July 30th, 2012
Active User, very eHealthy
"She has me doing lower an exercises and she is telling me to tuck in my abs and butt to make the curve in my back go away and she said not to so any extension in my back because it hurts."

Your PT might think you have excessive lumbar lordosis this when the curve at the bottom of your spine is too large and your stomach and your butt stick out so to speak. Working into extension exacerbates this problem as an extended position of the lumbar spine is the same as an excessive lumbar curve. You might want to ask her about this to get a clearer picture of your problems

It would be nice if we were given the full picture by doctors and therapists it would make our choice of treatment clearer.
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replied July 31st, 2012
Hi Friends,
I am new here to this forum.I am here to learn and express my views with others.Few years back I got a serious back injury.Then for treatment I went to Dr. Bendiks, and it benefited me a lot. Now I am perfectly fine.
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